Core Competencies for Rutgers New Jersey Medical School - RBHS

Create a free account to sign-in. Medscape - Arterial Blood Gas Sampling - Go to the "Multimedia Library" to see the images and videos - Author(s): Mauricio Danckers, MD, Ethan D Fried, MD, MS, Mary L Windle, PharmD, and Vincent Lopez Rowe, MD - "Arterial blood gas (ABG) sampling by direct vascular puncture is a procedure often practiced in the hospital setting. The relatively low incidence of major complications, its ability to be performed at the patient’s bedside, and its rapid analysis make it an important tool used by physicians to direct and redirect the treatment of their patients, especially in patients who are critically ill."

The New England Journal of Medicine - Videos in Clinical Medicine - Arterial Puncture for Blood Gas Analysis - "This is a Video in Clinical Medicine from the New England Journal of Medicine. Arterial Puncture for Blood Gas Analysis Overview Radial arterial puncture for arterial blood gas analysis is a common procedure performed in medicine. It is a fundamental skill that all medical trainees need to acquire. This video will review radial arterial puncture in the adult population." - Shelly P. Dev, M.D., Melinda D. Hillmer, M.D., BSc.Phm., and Mauricio Ferri, M.D. N Engl J Med 2011; 364:e7 February 3, 2011 DOI: 10.1056/NEJMvcm0803851

Access Medicine - Harrison's Principles of Internal Medicine - Percutaneous Arterial Blood Gas Sampling - Author(s): Christian D. Becker, MD, PhD, FCCP, Mount Sinai Medical Center.

The New England Journal of Medicine - Videos in Clinical Medicine - Abscess Incision and Drainage - "Incision and drainage is the primary therapy for cutaneous abscess management, as antibiotic treatment alone is inadequate for treating many of these loculated collections of infectious material. Most localized skin abscesses without associated cellulitis can be managed with simple incision and drainage and do not require antibiotic treatment. Cutaneous abscesses have been described in all areas of the body, but are most commonly found in the axillae, buttocks, and extremities. This outpatient procedure is appropriate for many office settings, as well as for urgent care and emergency department practice environments." - Michael T. Fitch, M.D., Ph.D., David E. Manthey, M.D., Henderson D. McGinnis, M.D., Bret A. Nicks, M.D., and Manoj Pariyadath, M.D. N Engl J Med 2007; 357:e20 November 8, 2007 DOI: 10.1056/NEJMvcm071319

The New England Journal of Medicine - Videos in Clinical Medicine - Central Venous Catheterization - "The placement of a central venous line is an essential technique in the treatment of many hospitalized patients. This video will demonstrate the placement of a central venous catheter in the internal jugular vein with the use of one of several variations of the Seldinger technique. An additional video on subclavian line placement will be forthcoming." - Central Venous Catheterization Alan S. Graham, M.D., Caroline Ozment, M.D., Ken Tegtmeyer, M.D., Susanna Lai, M.P.H., and Dana A.V. Braner, M.D. N Engl J Med 2007; 356:e21 May 24, 2007 DOI: 10.1056/NEJMvcm055053

The New England Journal of Medicine - Videos in Clinical Medicine - Central Venous Catheterization - Subclavian Vein - "Evidence suggests that the risk of major central venous line complications, particularly line-related bloodstream infections, is lower when the subclavian approach is used. This video will identify the landmarks and procedure for placement of a subclavian central line." - Central Venous Catheterization - Subclavian Vein Dana A.V. Braner, M.D., Susanna Lai, M.P.H., Scott Eman, B.S., and Ken Tegtmeyer, M.D. N Engl J Med 2007;357:e26 December 13, 2007 DOI: 10.1056/NEJMvcm074357

Access Medicine - Harrison's Principles of Internal Medicine - Ultrasound-Guided Central Venous Catheter Placement - Author(s): Maria A. Yialamas, William Corcoran, Gyorgy Frendl, and Kurt Fink.

"These tutorials teach medical students and residents basic and more advanced Radiologic imaging including CT, US, MRI and Nuclear Medicine. Anatomy, the current menu of Radiologic tests utilized, a detailed approach to evaluating images, and the typical Radiologic presentation of common abnormalities are emphasized. The tutorials are voiced over and the answers to questions are formally tracked so that the user can assess his or her own progress. To view related teaching materials, please see eradiology.harvard.bidmc.edu." By: Gillian Lieberman, MD.

University of Virginia Health Sciences Center - Department of Radiology - Introduction to Chest Radiology. "This web site is intended as a self-tutorial for residents and medical students to learn to interpret chest radiographs with confidence. Technique, normal anatomy and common pathology are presented. Quizzes are provided for practice and self-assessment." By: Spencer B. Gay, M.D., Juan Olazagasti, M.D., Jack W. Higginbotham, M.D., Atul Gupta M.D., Alex Wurm M.D., Jonathan Nguyen M.D. Department of Radiology - University of Virginia Health Sciences Center.

University of Wisconsin - Department of Medicine and Public Health - Department of Family Medicine - Electrocardiogram (ECG) Course 1. Play video found on this webpage. By: Melissa Stiles MD, Dean Keller, MD. Dr. Dean Keller and Dr. Melissa Stiles discuss the basics of electrocardiogram (ECG) interpretation.

University of Wisconsin - Department of Medicine and Public Health - Department of Family Medicine - Electrocardiogram (ECG) Course 2. Play video found on this webpage. By: Melissa Stiles MD, Dean Keller, MD. Dr. Dean Keller and Dr. Melissa Stiles continue to discuss the basics of electrocardiogram (ECG) interpretation.

After accessing Bates' Visual Guide to Physical Examination Volumes 1-12 and following the directions found at the link above, select "Female Genitalia, Anus, and Rectum." A new menu will appear. Select "Examining External Female Genitalia, Examination of Internal Genitalia, or Rectovaginal Examination." Watch the video that follows.

Access Medicine - Williams Gynecology, 3e - Chapter 1. Well Woman Care - Medical History and Physical Examination - Introduction to the Basic Pelvic Exam - Author(s): Barbara L. Hoffman, MD, and Jordan Pietz.

The New England Journal of Medicine - Videos in Clinical Medicine - Pelvic Examination - "This video will demonstrate how to perform a comprehensive pelvic examination, which includes an examination of the external genitalia, a Papanicolaou test, a bimanual examination, as well as a rectovaginal examination. Indications Women should undergo a pelvic examination when they have vulvar and or vaginal complaints such as pain, discharge, abnormal bleeding, itching, and/or a mass." - Pelvic Examination Alison Edelman, M.D., M.P.H., JoDee Anderson, M.D., Susanna Lai, M.P.H., Dana A.V. Braner, M.D., and Ken Tegtmeyer, M.D. N Engl J Med 2007; 356:e26 June 28, 2007 DOI: 10.1056/NEJMvcm061320

The New England Journal of Medicine - Videos in Clinical Medicine - Female Urethral Catheterization - "Female urethral catheterization, the insertion of a catheter through the urethra into the urinary bladder to permit drainage of urine, is a fundamental skill for the practicing health care professional. This video discusses the indications for catheterization, the equipment available, the current methods of catheter insertion and maintenance, potential complications, and how to troubleshoot common problems." - Female Urethral Catheterization Rafael Ortega, M.D., Linda Ng, M.D., Pavan Sekhar, B.S., and Michael Song, M.A. N Engl J Med 2008; 358:e15 April 3, 2008 DOI: 10.1056/NEJMvcm0706671

Access Medicine - Harrison's Principles of Internal Medicine - Insertion of Female Urethral Catheter - Author(s): Jeffrey A. Stock, MD, and Ardavan Akhavan, MD.

Access Medicine - Harrison's Principles of Internal Medicine - Insertion of Male Urethral Catheter - Author(s): Jeffrey A. Stock, MD and Ardavan Akhavan, MD.

The New England Journal of Medicine - Videos in Clinical Medicine - Male Urethral Catheterization - "Urethral catheterization may be performed as either a therapeutic or a diagnostic procedure. Therapeutically, catheters may be placed to decompress the bladder in patients with acute or chronic urinary retention. In addition, catheters may be placed to facilitate bladder irrigation in patients with gross hematuria. Diagnostically, urinary catheters may be placed to obtain an uncontaminated urine sample for microbiologic testing, to measure urinary output in critically ill patients or during surgical procedures, or to measure post-void residuals. The only absolute contraindication to urethral catheterization is known or suspected urethral injury, usually in the setting of a pelvic fracture." - Male Urethral Catheterization Todd W. Thomsen, M.D., and Gary S. Setnik, M.D. N Engl J Med 2006; 354:e22 May 25, 2006 DOI: 10.1056/NEJMvcm054648

Nucleus - Health Literacy - Animation Library - Removal of Foley Catheter-Female - "This video demonstrates the step-by-step procedures for emptying the Foley bag and removing the Foley catheter from a woman. Symptoms requiring a follow-up call to the surgeon are listed."

Nucleus - Health Literacy - Animation Library - Removal of Foley Catheter-Male - "This video demonstrates the step-by-step procedures for emptying the Foley bag and removing the Foley catheter from a man. Symptoms requiring a follow-up call to the surgeon are listed."

Access Medicine - Harrison's Principles of Internal Medicine - Endotracheal Intubation - Author(s): Charles A. Morris and Emily Nelson Maher.

The New England Journal of Medicine - Videos in Clinical Medicine - Fiberoptic Intubation - "Fiberoptic intubation plays an important part in the management of a difficult airway and is recommended by many societies of anesthesia. It is primarily important for the management of the anticipated difficult airway, but can also be used to secure the airway in an unexpected situation. There are different techniques for both situations -- the nasal and oral approach in the awake and anesthetized status, respectively. The choice of the equipment and medication is primarily dependent on personal preference." - Fiberoptic Intubation Thomas Heidegger, M.D. N Engl J Med 2011; 364:e42 May 19, 2011 DOI: 10.1056/NEJMvcm0906443

The New England Journal of Medicine - Videos in Clinical Medicine - Nasogastric Intubation - "Common indications for nasogastric intubation include decompression of the GI tract in patients with bowel obstruction and gastric emptying in intubated patients to prevent aspiration. NG tubes may be placed as an adjunct for the delivery of oral agents, such as activated charcoal or oral radiographic contrast medium. NG tubes are often placed in patients with suspected upper GI hemorrhage. However, the sensitivity and negative predictive value of nasogastric aspirates for detecting active bleeding is suboptimal, and the absence of bloody return cannot be relied upon to rule out hemorrhage." - Nasogastric Intubation Todd W. Thomsen, M.D., Robert W. Shaffer, M.D., and Gary S. Setnik, M.D. N Engl J Med 2006; 354:e16 April 27, 2006 DOI: 10.1056/NEJMvcm050183

The New England Journal of Medicine - Videos in Clinical Medicine - Orotracheal Intubation - "Emergency orotracheal intubation is indicated in any situation in which definitive control of the airway is needed. Specific indications include cardiac or respiratory arrest, failure to protect the airway from aspiration, inadequate oxygenation or ventilation, and impending or existing airway obstruction. Orotracheal intubation is also commonly performed as part of the care of the critically ill patient with multisystem disease or injuries, and to facilitate control of the airway during surgical procedures requiring general anesthesia." - Orotracheal Intubation Christopher Kabrhel, M.D., Todd W. Thomsen, M.D., Gary S. Setnik, M.D., and Ron M. Walls, M.D. N Engl J Med 2007; 356:e15 April 26, 2007 DOI: 10.1056/NEJMvcm063574

The New England Journal of Medicine - Videos in Clinical Medicine - Basic Laceration Repair - "Lacerations are among the most common reasons for visits to emergency departments. Although most lacerations will heal without treatment, repair of these injuries reduces infection, scarring, and patient discomfort. Sutures, tissue adhesives, and wound tapes may all be used for laceration repair. Tissue adhesives and wound tapes are suitable for smaller lacerations that are not subject to substantial tension. In this video, however, we will demonstrate the use of simple interrupted sutures." - Basic Laceration Repair Todd W. Thomsen, M.D., Derek A. Barclay, M.D., and Gary S. Setnik, M.D. N Engl J Med 2006; 355:e18 October 26, 2006 DOI: 10.1056/NEJMvcm064238

The New England Journal of Medicine - Videos in Clinical Medicine - Lumbar Puncture - "This video will demonstrate safe and successful methods of performing lumbar puncture. Lumbar puncture is indicated for both diagnostic and therapeutic purposes. Also, the administration of spinal and epidural anesthesia involves the use essentially of the same technique. Analysis of cerebrospinal fluid may be helpful in the diagnosis of infectious processes such as meningitis, inflammatory diseases such as multiple sclerosis, cancers such as leukemia, and metabolic processes. Therapeutically, lumbar puncture allows for the intrathecal administration of chemotherapeutic agents and antibiotics. There are specific contraindications to lumbar puncture." - Lumbar Puncture Miles S. Ellenby, M.D., Ken Tegtmeyer, M.D., Susanna Lai, M.P.H., and Dana A.V. Braner, M.D. N Engl J Med 2006; 355:e12 September 28, 2006 DOI: 10.1056/NEJMvcm054952

Create a free account to sign-in. Medscape - Reference - Lumbar Puncture - Go to the "Multimedia Library" to see the images and videos - Author(s): Gil Z Shlamovitz, MD, Nirav R Shah, MD, MPH, Helmi L Lutsep, MD , Andrew K Chang, MD, Luis M Lovato, MD, and Mary L Windle, PharmD - "Lumbar puncture is a procedure that is often performed in the emergency department to obtain information about the cerebrospinal fluid (CSF).[1, 2, 3, 4] Although usually used for diagnostic purposes to rule out potential life-threatening conditions (eg, bacterial meningitis or subarachnoid hemorrhage), it is also sometimes used for therapeutic purposes (eg, treatment of pseudotumor cerebri). CSF fluid analysis can also aid in the diagnosis of various other conditions (eg, demyelinating diseases and carcinomatous meningitis)."

Please see the directions on how to view this resource found at the following link: http://libraries.rbhs.rutgers.edu/newarklib/PDF/BatesVideowithIE.pdf. After accessing Bates' Visual Guide to Physical Examination Volumes 1-12 and following the directions found at the link above, select "Male Genitalia, Hernias, Rectum, and Prostate." A new menu will appear. Select "Examining Male Genitalia" or "Assessing for Hernias." Watch the video that follows.

Access Medicine - DeGowin's Diagnostic Examination - Chapter 12. The Male Genitalia and Reproductive System - Physical Examination of the Male Genitalia and Reproductive System - Examination for Hernias of the Inguinal Region - Author(s): Richard LeBlond.

Access Medicine - The Male Genitourinary Exam - Author(s): Richard LeBlond.

Create a free account to sign-in. Medscape - Reference - Cardiopulmonary Resuscitation (CPR) - Go to the "Multimedia Library" to see the images and videos - Author(s): Catharine A Bon, MD, Baruch Berzon, MD, Joshua Schechter, MD, Andrew K Chang, MD, Mary L Windle, PharmD, Rick Kulkarni, MD, Benjamin S Abella, MD, MPH, Alena Lira, MD, Richard H Sinert, DO, and Noah T Sugerman, EMT - "Cardiopulmonary resuscitation (CPR) consists of the use of chest compressions and artificial ventilation to maintain circulatory flow and oxygenation during cardiac arrest. Although survival rates and neurologic outcomes are poor for patients with cardiac arrest, early appropriate resuscitation—involving early defibrillation—and appropriate implementation of post–cardiac arrest care lead to improved survival and neurologic outcomes."

Create a free account to sign-in. Medscape - Reference - Defibrillation and Cardioversion - Go to the "Multimedia Library" to see the images and videos - Author(s): Ashok K Kondur, MD, Luis C Afonso, MD, Raju V T Penumetcha, MD, Sony Jacob, MD, Suchitra Kamineni, MD, Masooma Athar, MBBS, Luis M Lovato, MD, Mary L Windle, PharmD, and Rick Kulkarni, MD - "Defibrillation is a nonsynchronized delivery of energy during any phase of the cardiac cycle, whereas cardioversion is the delivery of energy that is synchronized to the large R waves or QRS complex. Electrical cardioversion has now become a routine procedure and is used electively or emergently to terminate cardiac arrhythmias."

The New England Journal of Medicine - Videos in Clinical Medicine - Peripheral Intravenous Cannulation - "Peripheral Intravenous Cannulation Introduction The ability to obtain peripheral intravenous access is an essential skill for all physicians. Although considered one of the simplest invasive procedures, mastering this potentially lifesaving intervention requires refined skills and experience. Cannulating a vein, particularly a small one, can be challenging. The purpose of this video is to demonstrate how to access peripheral veins using an intravenous catheter." - Peripheral Intravenous Cannulation Rafael Ortega, M.D., Pavan Sekhar, M.D., Michael Song, M.D., Christopher J. Hansen, B.A., and Lauren Peterson N Engl J Med 2008; 359:e 26 November 20, 2008 DOI: 10.1056/NEJMvcm0706789

The New England Journal of Medicine - Videos in Clinical Medicine - Ultrasound-Guided Peripheral IV Placement - "Placement of peripheral intravenous (IV) catheters is a fundamental skill that all health care professionals should possess. Unfortunately, it can be difficult to obtain IV access in some patients, including obese patients, children, and patients who have undergone placement of many IVs or who have a history of difficult IV access." - Ultrasound-Guided Peripheral IV Placement Scott Joing, M.D., Seth Strote, M.D., Liberty Caroon, R.D.M.S., Christopher Wall, M.D., Jamie Hess, M.D., Chad Roline, M.D., Laura Oh, M.D., Ben Dolan, B.A., Robb Poutre, Kathleen Carney, R.N., David Plummer, M.D., and Robert Reardon, M.D. N Engl J Med 2012; 366:e38 June 21, 2012 DOI: 10.1056/NEJMvcm1005951

University of California Trauma Center Burn Unit - YouTube - Real Life Trauma Resuscitation.

Access Medicine - Harrison's Online - Phlebotomy - Author(s): Jeremy Matloff, MD.

Create a free account to sign-in. Medscape - Reference - Phlebotomy - Go to the "Multimedia Library" to see the images and videos - Author(s): Gil Z Shlamovitz, MD, Vincent Lopez Rowe, MD, and Francisco Talavera, PharmD, PhD - "Phlebotomy is a technique in which a needle is temporarily inserted into a vein to provide venous access for venous blood sampling. Veins have a 3-layered wall composed of an internal endothelium surrounded by a thin layer of muscle fibers, which in turn is surrounded by a layer of connective tissue."